Provider Demographics
NPI:1023254752
Name:STURM, SHARON SHAINDY (OTR/L)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:SHAINDY
Last Name:STURM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 KINGS HWY APT 4D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1642
Mailing Address - Country:US
Mailing Address - Phone:917-613-1454
Mailing Address - Fax:
Practice Address - Street 1:2424 KINGS HWY APT 4D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1642
Practice Address - Country:US
Practice Address - Phone:917-613-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012474-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency